Individual differences in legal and illicit cannabis purchasing behaviour in British Columbia, Canada: Findings from a 2021 cross-sectional survey.

BACKGROUND: Despite thousands of licensed cannabis retail stores operating across Canada, there remains a significant illicit cannabis market. Some cannabis users continue to buy cannabis from dealers, illicit stores, and/or illicit online retailers. METHODS: Data are from the 2021 British Columbia Cannabis Use Survey. Respondents (n = 8473) were 19 years or older, lived in British Columbia at the time of the survey, and reported using cannabis in the past 12 months. RESULTS: Buying cannabis from all types of illicit sources was more common among younger cannabis users, those who use cannabis more frequently and started using cannabis before the age of 17 (vs. 19 or older), and among those who co-use cannabis with other drugs. Specifically, buying cannabis from a dealer was more common among men, those with lower educational attainment, and those who seek the lowest prices when buying cannabis. In contrast, those using cannabis for medical (vs. non-medical) purposes were more likely to report getting cannabis from illicit retail stores, while buying cannabis from illicit websites was more common among people who use edible cannabis products. CONCLUSION: Consistent with other studies, younger and more frequent cannabis users were more likely to report buying cannabis from illicit sources. However, these findings suggest there is significant heterogeneity among those who buy cannabis from different types of illicit sources, which should be carefully considered when developing policies and strategies aimed at encouraging consumers to transition to legal sources.

Modeling Opioid Abuse: A Case Study of the Opioid Crisis in New England.

For the past two decades, the USA has been embroiled in a growing prescription drug epidemic. The ripples of this epidemic have been especially apparent in the state of Maine, which has fought hard to mitigate the damage caused by addiction to pharmaceutical and illicit opioids. In this study, we construct a mathematical model of the opioid epidemic incorporating novel features important to better understanding opioid abuse dynamics. These features include demographic differences in population susceptibility, general transmission expressions, and combined consideration of pharmaceutical opioid and heroin abuse. We demonstrate the usefulness of this model by calibrating it with data for the state of Maine. Model calibration is accompanied by sensitivity and uncertainty analysis to quantify potential error in parameter estimates and forecasts. The model is analyzed to determine the mechanisms most influential to the number of opioid abusers and to find effective ways of controlling opioid abuse prevalence. We found that the mechanisms most influential to the overall number of abusers in Maine are those involved in illicit pharmaceutical opioid abuse transmission. Consequently, preventative strategies that controlled for illicit transmission were more effective over alternative approaches, such as treatment. These results are presented with the hope of helping to inform public policy as to the most effective means of intervention.

Community correlates of change: A mixed-effects assessment of shooting dynamics during COVID-19.

This study examines changes in gun violence at the census tract level in Philadelphia, PA before and after the onset of the COVID-19 pandemic. Piecewise generalized linear mixed effects models are used to test the relative impacts of social-structural and demographic factors, police activity, the presence of and proximity to drug markets, and physical incivilities on shooting changes between 2017 and June, 2021. Model results revealed that neighborhood structural characteristics like concentrated disadvantage and racial makeup, as well as proximity to drug markets and police activity were associated with higher shooting rates. Neighborhood drug market activity and police activity significantly predicted changes in shooting rates over time after the onset of COVID-19. This work demonstrates the importance of understanding whether there are unique factors that impact the susceptibility to exogenous shocks like the COVID-19 pandemic. The increasing risk of being in a neighborhood with an active drug market during the pandemic suggests efforts related to disrupting drug organizations, or otherwise curbing violence stemming from drug markets, may go a long way towards quelling citywide increases in gun violence.

Illicit drugs seizures in 2013-2018 and characteristics of the illicit market within the Neapolitan area.

The study presents results of toxicological analysis performed on seized material in Neapolitan area in the period from 2013 to 2018. A constancy in THC and heroin percentages is evidenced (%THC ~10% and ~11.5% for marijuana and hashish; heroine: 20-24%), with mean values exceeding the European data. Data on cocaine revealed a constant increment of active principle percentage over the studied period (from 40% in 2013 to ~65% in 2018), with peak of 70% in 2017; also, number of samples exceeding the mean value increased over years. Active principles contents resulted higher than the ones reported in other Italian area ever the same period; marijuana was prevalent on hashish, confirming an Italian trend different from other European countries. A map of the Campania region evidenced two main "storage" districts, one corresponding to the city center and the second located in the northern part. If compared with literature data on the presence of local mafia, these areas are perfectly superimposable to those with the highest risk of homicides, thus confirming the degree of radicalization of local organizations and the relative weight of proceeds from drugs sale. Moreover, such radicalization within the territory seems to be the main reason of the absence of new psychoactive substances among the seized material.

Chemical and statistical analyses of blotter paper matrix drugs seized in the State of Rio de Janeiro.

Drugs of abuse are psychoactive substances illicitly distributed and used worldwide. In Rio de Janeiro, Brazil, they represent a public health issue and are directly related to several social problems. The recent increase in appearances of new psychoactive substances (NPS), derived from structural modifications of existing psychoactive substances, poses a threat to public health and forensic laboratories worldwide, as little is known about these substances. This study aimed to chemically and geographically map drugs of abuse from blotter papers seized by the Civil Police of Rio de Janeiro State (PCERJ) between 2006 and 2019. High-performance analytical techniques, such as gas chromatography-mass spectrometry (GC-MS) and Orbitrap mass spectrometry (Orbitrap-MS), combined with statistical analyses, were employed to characterize the seized samples. The most common chemical compounds in NPS found in this study were synthetic phenethylamines, i.e., molecules from the 25I-NBOH (2-(((4-iodo-2,5-dimethoxyphenethyl)amino)methyl)phenol) and 25I-NBOMe (2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine) families. Prior to 2014, the majority of seized blotter papers contained lysergic acid diethylamide (LSD) and were concentrated in the Metropolitan region. An upsurge in blotter paper seizures was observed from 2014 to 2017; the most common substances during this time were from the NBOMe family. NBOH compounds emerged in 2016 in coastal regions with high tourism, reaching over 1300 items only in 2017. Only one synthetic cannabinoid was found among the blotter papers seized in Rio de Janeiro between 2006 and 2019. The assembled chemical data and statistical analyses allowed the mapping and monitoring of the chemical profiles of the seized blotter papers, providing a strong foundation for the understanding of the origins and movement of these drugs around the RJ State.

Missouri's Fentanyl Problem: The China Connection.

Recently, Missouri has followed an overall upward trend in opioid overdose deaths. In 2018, Missouri was the state with the largest absolute and percentage increase in opioid-related overdose fatality rates per capita over the previous year (18.3% and 3.1/100,000). This increase occurred despite an overall decrease in U.S. opioid-related death rates in the same period. This report identifies illicitly manufactured fentanyl (IMF) (and analogues) as the drug most responsible for this rise in opioid deaths in Missouri, with stimulant overdoses (primarily from methamphetamine) in second place. Within Missouri, we find the areas where opioid deaths are highest: St. Louis and the city's fringe areas, following the national trend for high rates in fringe areas. Based on reports from CDC Wonder data, county medical examiners, law enforcement agencies, and drug addiction prevention agencies, we conclude that IMF and related synthetic opioids arriving from China are primarily responsible for fatal narcotic overdoses in Missouri. Despite the COVID-19 disruption of fentanyl manufacturing and distribution centers in and around Wuhan, China early in the pandemic, preliminary 2020 data from medical examiners' offices show an upswing in opioid deaths, an indicator that Chinese fentanyl producers have restored the supply chain.

High prevalence of Hepatitis C Virus infection among people who use crack cocaine in an important international drug trafficking route in Central-West Region Brazil.

In this study, the prevalence rate, associated risk factors and genetic diversity of hepatitis C virus (HCV) infection were determined among people who use crack from an international drug trafficking route in Central-West, Brazil. Blood samples were collected from 700 users of crack from Campo Grande and two border cities of Mato Grosso do Sul State and tested for HCV infection using serological and molecular testing methodologies. Anti-HCV was detected in 31/700 (4.5%, 95% CI: 2.9-6.0%) and HCV RNA in 26/31 (83.9%) of anti-HCV positive samples. Phylogenetic analysis of three HCV sub-genomic regions (5'UTR, NS5B and HVR-1) revealed the circulation of 1a (73.9%), 1b (8.7%) and 3a (17.4%) genotypes. Next-generation sequencing and phylogenetic analysis of intra-host viral populations of HCV HVR-1 showed a significant variation in intra-host genetic diversity among infected individuals, with 58.8% composed of more than one sub-population. Bayesian analysis estimated that the most recent common HCV ancestor for strains identified here was introduced to this region after 1975 following expansion of intravenous drug use in Brazil. Multivariate analyses showed that only 'ever having injected drugs' was independently associated with HCV infection. These results indicate an increasing spread of multiple HCV strains requiring public health intervention, such as harm reduction, testing services and treatment among crack users in this important border region of Central Brazil.

High rates of incarceration due to drug trafficking in the last decade in southern Brazil.

Introduction Drug-related crimes, especially drug trafficking, account for a large part of incarcerations not only in Brazil, but also worldwide. It is not clear whether the change in the drug law has contributed to the increase in the number of drug trafficking prisoners. Few studies have investigated gender differences and the growth of drug trafficking offenses in the Brazilian southern state of Rio Grande do Sul. Objective To investigate the growth of the prison population in the state of Rio Grande do Sul, emphasizing incarcerations for drug trafficking and gender differences. Method This was an ecological study using secondary data collected from official databases of the Brazilian National Penitentiary Department (Departamento Penitenciário [DEPEN]), affiliated with the Brazilian Ministry of Justice. Results Between 2006 and 2015, incarcerations increased by 27% (25% men, 83% women). Incarcerations for drug trafficking accounted for 11% of total arrests in 2006 (11% men, 20% women) and 45% in 2015 (47% men, 91% women), corresponding to an increase of 427% (415% among men, 723% among women). Conclusions Imprisonment for drug trafficking has increased considerably, especially among women. This may be due to factors such as: increase of drug trafficking, increase in the numbers of gangs in the state, and changes in the Brazilian drug law. These results highlight an emerging challenge in public health from the perspective of human rights and gender.

High rates of incarceration due to drug trafficking in the last decade in southern Brazil

Abstract Introduction Drug-related crimes, especially drug trafficking, account for a large part of incarcerations not only in Brazil, but also worldwide. It is not clear whether the change in the drug law has contributed to the increase in the number of drug trafficking prisoners. Few studies have investigated gender differences and the growth of drug trafficking offenses in the Brazilian southern state of Rio Grande do Sul. Objective To investigate the growth of the prison population in the state of Rio Grande do Sul, emphasizing incarcerations for drug trafficking and gender differences. Method This was an ecological study using secondary data collected from official databases of the Brazilian National Penitentiary Department (Departamento Penitenciário [DEPEN]), affiliated with the Brazilian Ministry of Justice. Results Between 2006 and 2015, incarcerations increased by 27% (25% men, 83% women). Incarcerations for drug trafficking accounted for 11% of total arrests in 2006 (11% men, 20% women) and 45% in 2015 (47% men, 91% women), corresponding to an increase of 427% (415% among men, 723% among women). Conclusions Imprisonment for drug trafficking has increased considerably, especially among women. This may be due to factors such as: increase of drug trafficking, increase in the numbers of gangs in the state, and changes in the Brazilian drug law. These results highlight an emerging challenge in public health from the perspective of human rights and gender.

Legislation targeting head shops selling new psychoactive substances and changes in drug-related psychiatric admissions: A national database study.

AIM: New psychoactive substance (NPS) use can negatively impact mental health and may result in drug-related psychiatric admissions (DRPA). Irish youth reported very high rates of NPS use by international standards, the most common being synthetic cannabinoids and cathinones. This occurred in the context of a rapid expansion in specialist high street shops, called head shops, selling NPS in 2010. Government responded to public protests about head shops by enacting legislation in May and August 2010 to end this trade. Many academics argued that such actions were futile. We sought to determine if changes in head shop activity coincided with changes in DRPA. METHOD: The national database on psychiatric admissions was examined focusing on young adults admitted from 2008 to 2012. Joinpoint regression analysis was utilized to examine for the presence of trend changes in DRPA. RESULTS: The monthly rate of DRPA was higher in 2010 than 2008, 2009 and 2012 (P < 0.01). Joinpoint regression analysis identified a significant downward trend change which occurred in July 2010 (95% CI Feb 2010 to April 2011). Young males aged 18 to 24 years showed evidence of greatest change, DRPA falling by 1.4% per month (95% CI 0.7 to 3.7% decline) from May 2010 to December 2012. CONCLUSIONS: Cessation of NPS sale by head shops coincided with a reversal in the upward trend of DRPA, this change being most evident in young men. While correlation does not imply causation, legislation which successfully targets the sale of NPS may result in reduced drug-related mental disorders.

Polytraumatization, Mental Health, and Delinquency Among Adolescent Gang Members.

Adolescent gang members are at high risk for polytraumatization (i.e., experiencing two or more types of trauma), which may contribute to behavioral problems, such as delinquency or drug distribution, and mental health symptoms, such as posttraumatic stress disorder (PTSD) and depression. The present study examined the associations between polytraumatization and these behavioral and mental health outcomes. We hypothesized that increased polytraumatization would lead to increased (b) mental health symptoms, (b) delinquency, and (c) drug distribution. Participants included 441 adolescent gang members (57.8% male; age range: 14-19 years) from a midsized city in the Midwestern United States. A path model was used to test hypotheses. A total of 88.0% of participants experienced polytraumatization, such as physical and sexual assault, involvement in accidents, or witnessing a death or injury. Polytraumatization was uniquely and positively associated with depressive and PTSD symptoms, delinquency, and drug distribution, ßs = .25-.50, ps < .001, explaining an additional 5.9%-22.5% of the variance in these outcomes beyond covariates. Untreated traumatic exposure among adolescent gang members may subsequently lead to poor behavioral and mental health outcomes. These results may inform prevention and intervention efforts focused on mental health and social justice among a high-risk adolescent population.

Outpatient management of individuals transporting drugs by body packing is feasible.

INTRODUCTION: Drug traffickers are increasingly making use of the human body for illegal drug transport. Three ways of intracorporeal drug transport are practiced, namely "body packing", "body stuffing" and "body pushing". Since police and border guards cannot accurately detect intracorporeal drug transport, authorities require medical professionals for examination and radiological imaging. The aim of this retrospective study was to assess outcomes in all presentations of suspected intracorporeal drug transport referred to the Emergency Department (ED) of the University Hospital of Basel. METHODS: We screened the electronic health records (EHRs) of all presentations to the ED between 1 January 2008 and 31 December 2017 for combinations of keywords "body", "pack", "stuff" and "push" in the diagnosis and history of presenting complaints. All presentations with suspicion of intracorporeal drug transport were included. Patient characteristics, imaging modality and the results of imaging were assessed. Outcomes were length of stay, hospitalisation, admission to the intensive care unit, surgical intervention and mortality. The main outcome was the rate of surgical interventions during follow-up in hospital and in prison. RESULTS: We included 363 presentations in 347 patients. The median age was 35 years and 46 (12.7%) were female. Positive results of imaging were found in 81 of 353 (22.9%) presentations assessed by imaging. In four presentations (1.1%), the result of imaging was indeterminate; in 10 presentations, no imaging was obtained owing to lack of consent or pregnancy. We observed 36 instances of body packing, 10 of body stuffing and 15 of body pushing, and 20 mixed or indeterminate presentations. The number of suspected presentations has risen over the last decade, and the relative number of positive results has almost remained stable over the last six years. No severe or life-threatening complications, interventions, or deaths were observed. Among the presentations with positive imaging results, ten (12.3%) were observed in hospital, as compared with four (1.5%) of those with negative results. CONCLUSIONS: Presentations have increased over the last decade while no severe complications or deaths were observed. The consistently low complication rate supports outpatient observation. Considering the ongoing discussion in media and politics, we suggest validation of medical, legal, and ethical guidelines.

Drug dealing on Facebook, Snapchat and Instagram: A qualitative analysis of novel drug markets in the Nordic countries.

INTRODUCTION AND AIMS: Internet use has changed drug dealing over the past decade owing to the emergence of darknet services. Yet, little is known about drug dealing in public online services. This study reports findings from a Nordic comparative study on social media drug dealing. It is the first in-depth study on the increase of digitally mediated drug dealing outside the cryptomarkets. DESIGN AND METHODS: A qualitative study using online ethnography and semi-structured interviews. One hundred and seven participants aged 16-45 years (mean age 23.1 years), with 83.2% being male, were interviewed. Data was coded in NVivo using general themes: modus operandi, trust and risk. RESULTS: Ethnographical data shows a high degree of drug-dealing activity on Facebook, Instagram, Snapchat and Facebook Messenger. Buyers and sellers also use encrypted platforms, such as darknet forums and the Wickr app on their smartphones. The medium used varies across the countries, as well as motivations for usage in connection with risk perceptions. DISCUSSION: Despite national differences, social media is a common tool used in selling and buying illegal drugs. Availability affects the prevalence of use of various social media; however, prevalence is also crucial for which media is used. Many of the participants report easily drifting in and out of social media dealing and buying, without being aware of the seriousness of the offence. CONCLUSION: Based on the differences in attachment to the seller career, we advise that policing strategies should be supplemented with-and even stand in the back of-prevention campaigns.

Sellers' risk perceptions in public and private social media drug markets.

INTRODUCTION: From the early use of pagers and cellular phones to the darknet and smartphones, technological developments have facilitated drug deals in various ways, especially by altering time and space boundaries. Traditional drug market literature theorises about how physical markets, within which sellers act according to their risk perceptions and motivation, are led by supply, demand, and enforcement. However, there is an almost absolute research gap in understanding how this relates to digital markets and social media markets in particular. It is expected that the plasticity of technology makes digital markets highly mouldable so that the sellers are able to shape markets according to their use. RESEARCH AIM: The aim of the study is to describe and understand drug dealing on social media within the structure of existing markets. We aim to do so by analysing how drug sellers' risk perceptions and motivations form and are formed by social media technology. METHODS: We conducted a three-month digital ethnographic study on Facebook and Instagram in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden), as well as 107 semi-structured qualitative interviews with sellers (2/3 of the sample) and buyers (1/3 of the sample) using online markets within the same countries. RESULTS: Drug dealing on social media varies according to the structure of the chosen media and users' risk perceptions and motivations. Two market forms are suggested: 1) public digital markets (e.g., Facebook groups and Instagram) allow sellers to expand their customer lists, but the risk is quite high, while 2) private digital markets are based on one-on-one communication and demand greater knowledge but are perceived as more secure. Sellers choose which media to use and how to use them based on perceived risk and, therefore, have a significant impact on the formation of social media drug markets.

Should we smoke it for you as well? An ethnographic analysis of a drug cryptomarket environment.

INTRODUCTION: Why aren't cryptomarkets more widely used? Researchers from a wide array of fields have attempted to answer this question by studying the size of drug cryptomarkets, the substances trafficked, and their structure. In this paper we address the potential acceptance of drug cryptomarkets by studying their perceived ease of use. METHODS: This paper draws on observational data collected over 350 h of unstructured observation during an ethnographic study conducted in April-September 2016 of the two most prominent drug cryptomarkets at the time, in addition to seven face-to-face semi-structured qualitative interviews. ANALYSIS: Use of cryptomarkets relies on specialised knowledge. The administrators of the cryptomarkets do not play a publicly visible role in facilitating or easing cryptomarket use while simultaneously expecting cryptomarket users to exhibit self-reliance. We argue that the current levels of complexity and obfuscation constructed in the cryptomarket environment act as a barrier to the widespread acceptance of this technology. DISCUSSION: Through studying cryptomarkets' potential for widespread use we have shed light on current barriers to their growth requirement of specialised knowledge in order to use cryptomarkets and no public efforts to bridge the knowledge gap on behalf of cryptomarket administrators. As cryptomarkets continue to develop the ease of use of these platforms are bound to change, and with them the likelihood that cryptomarket usage may increase.

Digital figurations in the online trade of illicit drugs: A qualitative content analysis of darknet forums.

INTRODUCTION: This article analyses the factors of trust, logistics, and conflict on darknet markets (DNMs) and forums that are dedicated to selling illicit drugs. The analysis is conducted by utilising Elias (1978) theoretical concept of 'figuration,' which refers to the communicative constellations that eventuate between actors. METHODS: A qualitative content analysis was applied to a sample collected from darknet forums related to darknet markets, independent forums with trade sections, and separate vendor shops. The main categories trust, logistics, and conflict are analysed, and certain subcategories are also explored, including operational security (opsec), vouching, and shilling. These terms are commonly used to describe the trading of drugs on the darknet. RESULTS: Users of DNMs and forums discuss vendors, their products, and security-related features. Vouching and shilling are attempts to strengthen trust, logistics are used to secure the trade, while conflicts reflected in forum discussion threads often arise when logistics fail. Logistics may fail due to different reasons and actors involved in the associated figurations. The (anticipated) presence of actors in disguise is crucial for all of the main categories. CONCLUSION: Notions of trust, logistics, and conflict express attempts to cope with or circumvent risks imposed on users of DNMs by other users (e.g., scamming) or law enforcement (e.g., the interception of packages). Due to the illicit nature of the trade, these notions have to be constantly negotiated through digital communication.

Research in fractured digital spaces.

The internet is a medium for research, a place for the exchange of drugs and knowledge, and a method for governing and surveilling drug users. Opportunities for drug research with and in digital spaces are expanding, using internet mediated methods such as online surveys, web scraping, and research with web communities and users of cryptomarkets and apps. As the sphere of social data grows, so does the degree to which data itself is a product of fractured, governed, privatised set of spaces. Research often has to work with these structural aspects and researchers have to be aware of the structural mediation of their data. The opportunities for research also demand that researchers consider the validity of traditional scientific hierarchies such as the assumed superiority of probability sampling, and parse the naturally occurring taxonomies that are produced by the systems they research. A positive development has been the growth of internet focused researchers who operate in and outwith the academy and who are creating an independent research infrastructure with potential for a democratic research politics.

Prevalence and correlates of selling illicit cannabis among people who use drugs in Vancouver, Canada: A ten-year prospective cohort study.

BACKGROUND: The illicit selling and use of cannabis is prevalent among marginalized people who use illicit drugs (PWUD). Given that participation in illicit drug markets has been previously associated with a range of health and social harms, we sought to examine the predictors of selling cannabis among PWUD in Vancouver, Canada, a setting with a de facto legalized cannabis market, on the eve of the planned implementation of legalized non-medical cannabis including measures to regulate the existing illicit market. METHODS: Multivariable generalized estimating equations (GEE) logistic regression was used to analyze longitudinal factors associated with selling illicit cannabis among three prospective cohorts of PWUD between September 2005 and May 2015. RESULTS: Among the 3258 participants included in this study, 328 (10.1%) reported selling illicit cannabis at baseline, and 46 (5.1%) initiated cannabis selling over the study period. In the multivariable analysis of the whole sample, factors significantly associated with selling cannabis included cannabis use (Adjusted Odds Ratio [AOR] = 4.05), dealing other drugs (AOR = 3.87), being male (AOR = 1.83), experiencing violence (AOR = 1.40), non-medical prescription opioid use (AOR = 1.32), non-custodial involvement in the criminal justice system (AOR = 1.31), being stopped by police (AOR = 1.30), crack use (AOR = 1.25), homelessness (AOR = 1.23), age (AOR = 0.96 per year) and participation in sex work (AOR = 0.67) (all p < 0.05). The subanalyses indicated that dealing drugs other than cannabis, cannabis use, and non-custodial involvement in the criminal justice system were the only factors significantly associated with selling cannabis in all four subgroups. CONCLUSION: These findings support existing evidence indicating that selling illicit cannabis is often a survival-driven strategy to support the basic needs and substance use of some PWUD. Our findings suggest jurisdictions with planned or impending cannabis legalization and regulation should consider the vulnerability of PWUD when seeking to eradicate illicit cannabis markets, for example, in setting criminal penalties for selling cannabis outside of regulatory frameworks.